1. Field of the Invention
The invention relates to surgical devices and methods and, specifically, to devices and methods for closing the chest.
2. Description of Related Art
A median sternotomy is a surgical procedure in which a vertical incision is made along the midline of the sternum and the sternum is divided. Median sternotomies provide access for thoracic surgical procedures, including coronary artery bypass and heart transplant. In 2002, 709,000 median sternotomies were performed in the United States.
When the surgical procedure that necessitated the median sternotomy is complete, the sternum is closed. Typically, needles are used to loop wire through the manubrium, the bone that defines the top of the sternum. Below the manubrium, wires are looped through the intercostal spaces and around the sternum. The loops of wire are cut to create individual lengths of wire, and the ends of those lengths of wire are twisted together to tension them.
Certain difficulties arise with the traditional manner of closing a median sternotomy. First, it can be difficult for the surgeon to estimate the necessary amount of closure force correctly. Additionally, threading the wire around and through the sternum creates an increased risk of organ puncture. Moreover, after the procedure is performed, other difficulties may arise. For example, the patient may have a foreign body reaction, and the presence of metal wires may preclude or restrict the use of certain imaging techniques, like magnetic resonance imaging (MRI). Ultimately 3-5% of patients may require a re-sternotomy due to inadequate closure or complications.